Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis.
Admission Serum Iron as an Independent Risk Factor for Postoperative Delayed Cerebral Ischemia Following Aneurysmal Subarachnoid Hemorrhage: A Propensity-Matched Analysis.
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入院血清铁作为动脉瘤性蛛网膜下腔出血术后迟发性脑缺血的独立危险因素：倾向匹配分析
DOI：
10.3390/brainsci12091183
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发表时间：
2022-09-02
期刊：
影响因子：
3.3
通讯作者：
Kang, De-Zhi
中科院分区：
文献类型：
--
作者：
Zhang, Yi-Bin;Zheng, Feng;Stavrinou, Lampis;Wang, Hao-Jie;Fan, Wen-Jian;Yao, Pei-Sen;Lin, Yuan-Xiang;Goldbrunner, Roland;Zheng, Shu-Fa;Stavrinou, Pantelis;Kang, De-Zhi
本研究旨在探讨动脉瘤性蛛网膜下腔出血（aSAH）后血清铁（SI）与迟发性脑缺血（DCI）的关系。我们回顾性分析了985例连续诊断为aSAH的成年患者。记录人口统计学、临床和实验室数据。采用单因素和多因素分析来评估SI和DCI之间的关系。采用倾向分数匹配（PSM）分析，减少混杂。术后发生DCI的患者占14.38%。在有严重临床情况和严重aSAH的aSAH患者中，入院时SI较低。SI与WFNS分级（r = - 0.3744, p < 0.001）和改良Fisher （mFisher）分级（r = - 0.2520, p < 0.001）呈负相关。多变量分析显示，较低的SI与DCI独立相关[比值比（OR） 0.281, 95%可信区间（CI） 0.177-0.448, p < 0.001]，而WFNS分级和mFisher分级则无相关性。DCI的受者-工作特征（ROC）曲线分析得出曲线下面积（AUC）为0.7，最佳截止值为7.5 μmol/L （95% CI为0.665 ~ 0.733,p < 0.0001）。PSM显示，DCI组的SI明显低于非DCI组（10.91±6.86 vs. 20.34±8.01 μmol/L, p < 0.001）。在多变量分析中，低SI仍然是DCI的重要独立预测因子，也是aSAH的独立不良预后因素（OR 0.363, 95% CI 0.209-0.630, p < 0.001）。PSM后SI对不良预后的预测性能对应的AUC为0.718。入院时较低的SI与WFNS分级、mFisher分级显著相关，并预测aSAH后90天的DCI和不良预后。
This study aimed to investigate the association between serum iron (SI) and postoperative delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). We retrospectively analyzed 985 consecutive adult patients diagnosed with aSAH. Demographic, clinical, and laboratory data were recorded. Univariate and multivariate analyses were employed to assess the association between SI and DCI. Propensity-score matching (PSM) analysis was implemented to reduce confounding. Postoperative DCI developed in 14.38% of patients. Lower SI upon admission was detected in aSAH patients with severe clinical conditions and severe aSAH. SI was negatively correlated with WFNS grade (r = −0.3744, p < 0.001) and modified Fisher (mFisher) grade (r = −0.2520, p < 0.001). Multivariable analysis revealed lower SI was independently associated with DCI [odds ratios (OR) 0.281, 95% confidence interval (CI) 0.177–0.448, p < 0.001], while WFNS grade and mFisher grade were not. The receiver-operating characteristics (ROC) curve analysis of SI for DCI gave an area under the curve (AUC) of 0.7 and an optimal cut-off of 7.5 μmol/L (95% CI 0.665 to 0.733, p < 0.0001). PSM demonstrated the DCI group had a significantly lower SI than the non-DCI group (10.91 ± 6.86 vs. 20.34 ± 8.01 μmol/L, p < 0.001). Lower SI remained a significant independent predictor for DCI and an independent poor prognostic factor of aSAH in multivariate analysis (OR 0.363, 95% CI 0.209–0.630, p < 0.001). The predictive performance of SI for poor outcome had a corresponding AUC of 0.718 after PSM. Lower SI upon admission is significantly associated with WFNS grade, mFisher grade, and predicts postoperative DCI and poor outcome at 90 days following aSAH.
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DOI：
10.1038/jcbfm.2010.137
发表时间：
2010-11
期刊：
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
影响因子：
--
作者：
通讯作者：
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影响因子：
2.7
作者：
Ma X;Lan F;Zhang Y
通讯作者：
Zhang Y
影响因子：
3.4
作者：
Cai L;Zeng H;Tan X;Wu X;Qian C;Chen G
通讯作者：
Chen G
影响因子：
8
作者：
Krisai, Philipp;Leib, Stefanie;Conen, David
通讯作者：
Conen, David
DOI：
10.1073/pnas.1412833112
发表时间：
2015-01-27
影响因子：
11.1
作者：
Leclerc, Jenna L.;Blackburn, Spiros;Dore, Sylvain
通讯作者：
Dore, Sylvain